Ceyda Anar1 , Oğuzhan Okutan2 , Funda Coşkun3 , Nilgün Yılmaz Demirci4 , Berna Akıncı Özyürek5 , Ezgi Erdem Türe6 2Department of Pulmonology, İstanbul Maltepe University Faculty of Medicine, İstanbul, Türkiye
3Department of Pulmonology, Bursa Uludag University Faculty of Medicine, Bursa, Türkiye
4Department of Pulmonology, Gazi University Faculty of Medicine, Ankara, Türkiye
5Department of Pulmonology, Ankara Atatürk Sanatorium Training and Research Hospital Faculty of Medicine, Ankara, Türkiye
6Department of Pulmonology, Etlik City Hospital, Ankara, Türkiye
Abstract
Background And Aim: Progressive Pulmonary Fibrosis (PPF) depending on the underlying disease, there is no complete consensus on diagnosis, follow-up, and treatment approach in our country, as worldwide. It is aimed to evaluate about approaches to PPF patients by pulmonologists and rheumatologists through a questionnaire.
Methods: The link to a web-based questionnaire, consisting of 23 questions, has been prepared to assess the facilities of physicians' departments and their approaches to the diagnosis, follow-up, and treatment for patients with PPF. The questionnaire was sent doctors’ personal e-mail adresses. The responses of participants were reviewed.
Results: In this study, 91 pulmonologists and 39 rheumatologist completed an online survey. Of the participants, 44% had less than 10 years, 35% had 10-25 years and 21% had more than 25 years of professional experience. Doing a multidisciplinary council in their hospitals’ rate was 63%, working with a thoracic radiologist’s rate was 71%, and working with pathologists studying interstitial lung diseases’ (ILD) rate was 40%. The most common underlying primary diseases were rheumatoid arthritis-associated ILD (46.2%) and systemic sclerosis-associated ILD (45.4%). Used methods during follow-ups were respiratory function tests (90%), carbon monoxide diffusion test (84%), high-resolution computed tomography (79%), and pulmonary symptoms (79%). Used first-line medications for the underlying disease were steroids (85%), second-line medications were mycophenolate mofetil (58.5%). Antifibrotic drug treatment was given by 85% of participant and 78.5% of them would use a combination of antifibrotic and immunosuppressive agents. While 28% of the participants did not experience any hesitation in the diagnosis and treatment of PPF; the absence of a multidisciplinary team (35%) and the interpretation of radiological findings (31.5%) were the most hesitated situations.
Conclusıons: In this study, multidisciplinary councils were important for physicians in PPF patients. Although management of PPF patients varied, the physicians’ approach to diagnosis, follow-up and treatment of PPF patients were similar with the PPF guidelines’ recommendations.
